Calculations I

Question 1

Ferrous sulfate tablets USP contains 325 mg of ferrous sulfate in each tablet. How many
milligrams of elemental iron is contained in each ferrous sulfate 325 mg tablet? (Answer must be
numeric; no units or commas; round the final answer to the nearest WHOLE number.)

Question 2

A pharmacist has an order for parenteral nutrition that includes 850 mL of D50%. The
pharmacist checks the supplies and finds the closest strength available is D70%. How many mL
of D70% will provide an equivalent energy requirement?

Answer
A 350 mL
B 405 mL
C 500 mL
D 607 mL
E 850 mL

Question 3

Using the total energy expenditure (TEE) equation, calculate the total non-protein caloric
requirement for a patient with third degree burns on 50% of his body (stress factor 1.7). The
patient is a 58 year old male who weighs 190 pounds and measures 5'11" in height. Activity
factor is 1.2. The BEE for this patient is 1,764 kcal/day, calculated using the Harris-Benedict
equation. (Answer must be numeric; no units or commas; round final answer to the nearest
WHOLE number.)

Question 4

What is the osmolarity, in mOsmol/L, of 1/2 normal saline (0.45% NaCl)? M.W. = 58.5.
(Answer must be numeric; no units or commas; round final answer to the nearest WHOLE
number.)

Question 5

How many milligrams of potassium chloride are present in 12 mEq? (M.W. = 74.5) (Answer
must be numeric; no units or commas.)

Question 6

A pediatric patient is starting enteral nutrition with Nutren 2.0 premixed formula today. The
patient weighs 21 pounds and requires 1.4 g/kg/day of protein. If Nutren 2.0 provides 16 g/dL of
protein, how many milliliters of Nutren 2.0 are required per day to meet the patient's protein
requirement? (Answer must be numeric; no units or commas, round final answer to nearest
WHOLE number.)

Question 7

Acetic acid has a pKa of 4.8. Which of the following statement/s are correct? (Select ALL that
apply.)

Answer

A The pKa is the pH at which half the compound is protonated (H+) and half is unprotonated.
B When the pH equals the pKa there is 50% ionization.
C When the pH and pKa are the same it is called the neutralization point.
D Acetic acid acts as a weak base at physiologic pH.
E An acid picks up protons released by bases in solution.

Question 8

Richard Steinberg is admitted to the hospital. His medication orders are as follows:

Demographics/Vitals:
Age: 73 Weight: 185 lbs
BP: 145/92 mmHg HR: 72 BPM

Medication Orders:
2/16
Norvasc 10 mg PO daily
D5 1/2NS +
20 mEq KCl at 50 ml/hr
Protonix 40 mg daily
Lovenox 40 mg daily
Atenolol 100 mg PO daily

2/17
D/C IV fluid from 2/16
Potassium chloride 20 mEq PO BID
Norvasc 10 mg PO daily
D5 1/2NS at 50 ml/hr
Protonix 40 mg daily
Lovenox 40 mg daily
Atenolol 100 mg PO daily

2/18:
D/C IV fluid from 2/17
D/C KCl PO
NS 1 liter +
7 mEq Ca gluconate at 40 mL/hr
Norvasc 10 mg PO daily
Protonix 40 mg daily
Lovenox 40 mg daily
Atenolol 100 mg PO daily

Question:
On February 16th, Mr. Steinberg was off the floor for procedures and tests most of the morning
and his 1 liter bag of IV fluid + KCl was not started until 1300. The physician wants the patient
to receive the entire 20 mEq of potassium today. What rate (mL/hr) should the fluid be run at to
ensure that Mr. Steinberg gets 20 mEq of potassium on February 16th and his 1 liter bag does not
run out before midnight? (Answer must be numeric; no units or commas; round final answer to
the nearest WHOLE number.)

Question 9

How many grams of NaCl are in 500 mL of 1/2 NS? (Answer must be numeric; no units or
commas; include a leading zero when answer is less than 1.)

Question 10

How many milligrams of sodium thiosulfate (M.W. = 158) are represented by 0.25 mmol?
(Answer must be numeric; no units or commas; include a leading zero when answer is less than
1; round final answer to the nearest TENTH.)

Question 11

A reconstituted solution containing 500 mg of ganciclovir in 20 mL of sterile water for injection

is added to 500 mL of 5% dextrose in water. The infusion is to be administered over 2 hours. If
the infusion set delivers 15 drops/mL, what should the flow rate be to administer the bag over the
designated time interval?

Answer

A 16 drops/minute
B 33 drops/minute
C 63 drops/minute
D 65 drops/minute
E 71 drops/minute

Question 12

A patient requires 36 mmol of phosphate and 90 mEq of potassium in their PN. The pharmacy
has stock solutions of potassium phosphate (3 mmol of phosphate and 4.4 mEq potassium per
mL) and potassium chloride (2 mEq potassium/mL). How many milliliters of potassium chloride
are required? (Answer must be numeric; no units or commas; round final answer to the nearest
WHOLE number.)

Question 13

What is the weight in grams of 250 mL of concentrated acetic acid that has a specific gravity of
1.2? (Answer must be numeric; no units or commas; include a leading zero when answer is less
than 1; round the final answer to the nearest WHOLE number.)

Question 14

LK is admitted to the medical floor for a hypertensive emergency. His medication orders are as
follows:

Demographics/Vitals:
Age: 61 Weight: 185 lbs
BP: 215/101 mmHg HR: 108 BPM

Medications:
March 4:
Nitroprusside drip 50 mg/250 mL
start at 0.5 mcg/kg/min
titrate by 0.5 mcg/kg/min Q10min
Clonidine 0.1 mg PO BID
D5NS at 60 ml/hr
Protonix 40 mg daily
Zoloft 50 mg PO daily
Heparin 5,000 units SC BID

March 5:
Nitroprusside drip 50 mg/250 mL
continue to titrate PRN
max rate = 10 mcg/kg/min
Clonidine 0.1 mg PO BID
D5 1/2NS at 50 ml/hr
Protonix 40 mg daily
Zoloft 50 mg PO daily
Heparin 5,000 units SC BID

How many milliequivalents of sodium chloride will LK receive per day from the IV fluid
ordered on March 5th? (MW of Na = 23; MW of Cl = 35.5). (Answer must be numeric; no units
or commas; round final answer to the nearest WHOLE number.)
Question 15

The pharmacy receives the following PN order. Using Aminosyn 15%, calculate how many
milliliters of amino acids should be added to the PN. (Answer must be numeric; no units or
commas; round final answer to the nearest WHOLE number.)

Item/Quantities:
Dextrose 270 g
Amino acids 60 g
Sodium chloride 38 mEq
Sodium acetate 16 mEq
Potassium 40 mEq
Magnesium sulfate 10 mEq
Phosphate 21 mmol
Calcium 4.45 mEq
MVI-12 5 mL
Trace elements 1 mL
Vitamin K-1 0.5 mg
Famotidine 10 mg
Regular insulin 40 units

Sterile water qs ad 980 mL

Question 16

A hospital pharmacist receives a prescription for 3% saline for a patient in the Neuro ICU. The
premixed 3% saline bags that the pharmacy normally stocks are on backorder. How many
milliliters of 23.4% NaCl will need to be added to a 1 liter bag of normal saline to prepare 3%
saline for this patient? (MW of Na = 23; MW of Cl = 35.5). (Answer must be numeric; no units
or commas; round final answer to the nearest TENTH.)

Question 17

A pharmacist needs to meet 736 calories using 20% lipids. How many mL are required? (Answer
must be numeric; no units or commas.)

Question 18

A pharmacist has a prescription for a compounded 1% hydrocortisone cream. She will add 2.5%
hydrocortisone cream to 112 grams of 0.25% hydrocortisone cream to prepare the 1% cream.
The 2.5% cream and the 0.25% cream should be mixed in a ratio of 1 part 2.5% cream to how
many parts of 0.25% cream? (Answer must be numeric; no units or commas.)
Question 19

Calculate the body mass index (BMI) for a male who is 5'9" tall and weighs 95 kg. (Answer must
be numeric; no units or commas; round final answer to the nearest WHOLE number.)

Question 20

Martin Syde is a 73 year-old male who weighs 205 pounds. What is his CrCl using the
Cockcroft-Gault equation? (Answer must be numeric; no units or commas; round final answer to
the nearest WHOLE number.)

Labs:
Na (mEq/L) = 140 (135 – 145)
K (mEq/L) = 4.5 (3.5 – 5)
Cl (mEq/L) = 101 (95 – 103)
HCO3 (mEq/L) = 25 (24 – 30)
BUN (mg/dL) = 20 (7 – 20)
SCr (mg/dL) = 1.4 (0.6 – 1.3)
Glucose (mg/dL) = 122 (100 – 125)
Ca (mg/dL) = 8.9 (8.5 – 10.5)
Mg (mEq/L) = 2.1 (1.3 – 2.1)
PO4 (mg/dL) = 3.1 (2.3 – 4.7)
A1C (%) = 9.8
INR = 0.9 (0 - 1.2)

Question 21

A patient has the following ABG: pH = 7.16, paCO2 = 60, HCO3 = 28 What is the acid-base
disorder present in this patient?
Answer

A Metabolic acidosis
B Respiratory acidosis
C Metabolic alkalosis
D Respiratory alkalosis
E This is a normal ABG

Question 22

A patient has been receiving 400 mL of an enteral mixture that contains 532 mOsm/L. The
pharmacist will reduce the contents to 380 mOsm/L. How many milliliters of bacteriostatic water
should be added to the bag? Round to the nearest WHOLE number.
Answer

A 160 mL
B 350 mL
C 380 mL
D 400 mL
E 560 mL

Question 24

After compounding a PN formula, the pharmacist notes that the solution is hazy and there is a
precipitate visible when the bag is agitated. The precipitate is most likely to be which of the
following?

Answer

A KCl
B NaPO4
C MgCl
D CaPO4
E NaCl

Question 24

How many milliliters (mL) of Mylanta suspension are contained in each dose of prescription
below?

Belladonna Tincture 30 mL
Phenobarbital 70 mL
Mylanta susp. qs. ad 200 mL
Sig 20 mL BID

Answer

A 2.5 mL Mylanta per dose

B 5 mL Mylanta per dose
C 10 mL Mylanta per dose
D 20 mL Mylanta per dose
E 40 mL Mylanta per dose
Question 25

A pharmacist dissolves 4 ketoconazole tablets, each containing 200 mg, into a ointment liquid
base to prepare 45 mL of a topical solution. What is the percentage strength (w/v) of
ketoconazole in the prescription? (Answer must be numeric; no units or commas; include a
leading zero when answer is less than 1; round final answer to the nearest TENTH.)

Question 26

Express 0.0001% in parts per million (PPM). (Answer must be numeric; no units or commas;
include a leading zero when answer is less than 1.)

Question 27

A patient has the following differential:

WBC = 12.2 X 10^3 cells/mm^3

Segs = 15%
Bands = 10%.

Calculate the ANC. (Answer must be numeric; no units or commas.)

Question 28

The pharmacy receives the following PN order. The pharmacy has calcium gluconate 10%
(0.465 mEq/mL) in stock. How many milliliters (mL) of calcium gluconate 10% should be added
to the PN? (Answer must be numeric; no units or commas; round final answer to the nearest
TENTH.)

Item/Quantities:
Dextrose 270 g
Amino acids 60 g
Sodium chloride 38 mEq
Sodium acetate 16 mEq
Potassium 40 mEq
Magnesium sulfate 10 mEq
Phosphate 21 mmol
Calcium 4.45 mEq
MVI-12 5 mL
Trace elements 1 mL
Vitamin K-1 0.5 mg
Famotidine 10 mg
Regular insulin 40 units
Sterile water qs ad 980 mL

Question 29

A lorazepam injection contains 4 mg of lorazepam per milliliter. Calculate the ratio strength of
lorazepam in the injection. (Answer must be numeric; no units or commas; do not enter the 1 and
the colon; enter only the number after the colon, as shown here with Xs: 1:XXX.)

Question 30

Which of the following is the principal intracellular cation?

Answer

A Sodium
B Magnesium
C Calcium
D Potassium
E Manganese

Question 31

The pharmacist receives a prescription for "Erythromycin Ethylsuccinate 200 mg/5 mL, Sig: 5
mL PO TID x 10 days, until all taken". The pharmacist dispensed 4 ounces to the patient. How
many days of therapy will the patient be short?

Answer

A 1 day
B 2 days
C 3 days
D 4 days
E 5 days

Question 32

A patient has the following differential:

WBC = 8.5 X 10^3 cells/mm^3

Segs = 12%
Bands = 8%.
Calculate the ANC. (Answer must be numeric; no units or commas.)
Question 33

A weak acid with a pKa of 8 is added to a solution with a pH of 9. Choose the correct statement:

Answer

A The compound will be 100% ionized.

B The compound will be >50% ionized.
C The compound will be >50% unionized.
D The compound will be 100% unionized.
E The compound will be 50% ionized and 50% unionized.

Question 34

Richard Steinberg is admitted to the hospital. His medication orders are as follows:

Demographics/Vitals:
Age: 73 Weight: 185 lbs
BP: 145/92 mmHg HR: 72 BPM

Medication Orders:
2/16
Norvasc 10 mg PO daily
D5 1/2NS +
20 mEq KCl at 50 ml/hr
Protonix 40 mg daily
Lovenox 40 mg daily
Atenolol 100 mg PO daily

2/17
D/C IV fluid from 2/16
Potassium chloride 20 mEq PO BID
Norvasc 10 mg PO daily
D5 1/2NS at 50 ml/hr
Protonix 40 mg daily
Lovenox 40 mg daily
Atenolol 100 mg PO daily

2/18:
D/C IV fluid from 2/17
D/C KCl PO
NS 1 liter +
7 mEq Ca gluconate at 40 mL/hr
Norvasc 10 mg PO daily
Protonix 40 mg daily
Lovenox 40 mg daily
Atenolol 100 mg PO daily

Question:
The pharmacist has 10% calcium gluconate vials that are labeled to contain 0.465 mEq/mL. How
many milliliters of calcium gluconate are required to prepare the fluid ordered on February 18th?
(Answer must be numeric; no units or commas; round final answer to the nearest WHOLE
number.)

Question 35

How many milliliters of a 1:5000 (w/v) solution of boric acid can be made from 50 mL of a 0.4%
solution? (Answer must be numeric; no units or commas; round the final answer to the
nearest WHOLE number.)

Question 36

LK is admitted to the medical floor for a hypertensive emergency. His medication orders are as
follows:

Demographics/Vitals:
Age: 61 Weight: 185 lbs
BP: 215/101 mmHg HR: 108 BPM

Medications:
March 4:
Nitroprusside drip 50 mg/250 mL
start at 0.5 mcg/kg/min
titrate by 0.5 mcg/kg/min Q10min
Clonidine 0.1 mg PO BID
D5NS 1,000 mL at 60 ml/hr
Protonix 40 mg daily
Zoloft 50 mg PO daily
Heparin 5,000 units SC BID

March 5:
Nitroprusside drip 50 mg/250 mL
continue to titrate PRN
max rate = 10 mcg/kg/min
Clonidine 0.1 mg PO BID
D5 1/2NS 1,000 mL at 50 ml/hr
Protonix 40 mg daily
Zoloft 50 mg PO daily
Heparin 5,000 units SC BID

At what rate (mL/hr) should the nitroprusside drip have been started at on March 4th? (Answer
must be numeric; no units or commas; round final answer to the nearest TENTH.)

Question 37

A pharmacy is preparing a PN order for 330 g of dextrose. How many mL of dextrose are
required if the stock concentration of dextrose is 20%? (Answer must be numeric; no units or
commas.)

Question 38

If 150 capsules contain 400 mg of an active ingredient, how many milligrams of the active
ingredient will 84 capsules contain? (Answer must be numeric; no units or commas; round the
final answer to the nearest WHOLE number.)

Question 39

How many milligrams of dextrose are in 50 mL of D5W? (Answer must be numeric; no units or
commas; include a leading zero when answer is less than 1.)

Question 40

The total energy expenditure (TEE) using nonprotein calories for a patient is 2,645 kcal/day. The
patient is receiving 1,526 kcal from dextrose and 890 kcal from protein. How many kcal should
be provided by the lipids? (Answer must be numeric; no units or commas.)

Question 41

How many moles are equivalent to 890 mg of potassium iodide? (M.W. = 166). (Answer must be
numeric; no units or commas; include a leading zero when answer is less than 1; round final
answer to the nearest THOUSANDTH.)

Question 42

What is the pH of a solution containing 0.5 mole of a weak acid and 0.1 mole of its salt? (pKa of
the acid = 4.75). (Answer must be numeric; no units or commas; include a leading zero when
answer is less than 1; round final answer to the nearest HUNDREDTH.)
Question 43

A patient is taking 2 calcium carbonate tablets once daily. Each weighs 1,500 mg total (non-
elemental) weight. She wishes to trade her calcium tablets for the citrate form. How many 750
mg citrate tablets (by weight) will she need to provide the same daily dose? (Answer must be
numeric; no units or commas; round final answer to the nearest WHOLE tablet.)

Question 44

If a solution contains 20 g of glycerol and 5 g of codeine, what is the codeine percentage strength
(w/w) of the solution? (Answer must be numeric; no units or commas; include a leading zero
when answer is less than 1.)

Question 45

Which range represents the best choice for normal values of the serum creatinine?

Answer

A 0.5 - 0.7 mg/dL

B 0.1 - 0.3 mg/dL
C 0.17 - 0.43 mg/dL
D 0.6 - 1.3 mg/dL
E 1.8 - 4.3 mg/dL

Question 46

Calculate the anion gap for a patient with the following lab values: (Answer must be numeric; no
units or commas.)

Labs:
Na (mEq/L) = 132 (135 – 145)
K (mEq/L) = 3.7 (3.5 – 5)
Cl (mEq/L) = 98 (95 – 103)
HCO3 (mEq/L) = 14 (24 – 30)
BUN (mg/dL) = 13 (7 – 20)
SCr (mg/dL) = 1.0 (0.6 – 1.3)
Glucose (mg/dL) = 276 (100 – 125)
Ca (mg/dL) = 8.9 (8.5 – 10.5)
Mg (mEq/L) = 1.5 (1.3 – 2.1)
PO4 (mg/dL) = 2.6 (2.3 – 4.7)
INR = 0.9 (0 - 1.2)
PT (sec) = 11 (10 - 13)
aPTT (sec) = 26 (22 – 38)
A1C (%) = 9.8
WBC (cells/mm^3) =
6.2 (4 – 11 x 10^3)
Hgb (g/dL) =
14.5 (13.5 – 18 male)
Hct (%) =
43.4 (38 – 50 male)
Plt (cells/mm^3) =
342 (150 – 450 x 10^3)
Albumin (g/dL) = 3.9 (3.5 – 5)
AST (IU/L) = 25 (10 – 40)
ALT (IU/L) = 12 (10 – 40)

Question 47

The pharmacy receives a prescription for 80 grams of 2.5% hydrocortisone cream. Due to a
medication shortage, the pharmacist must compound this with the 5% and 1% hydrocortisone
creams in stock. How many grams of the 5% cream will be used to compound this
prescription? (Answer must be numeric; no units or commas.)

Question 48

A pharmacist receives an order for the following compounded prescription for benzocaine
ointment:

Benzocaine
100 g
Polyethylene glycol 400
600 g
Polyethylene glycol 3350
qs ad 1000 g

The pharmacist has benzocaine and polyethylene glycol 3350 powders and polyethylene glycol
400 liquid (SG = 1.13). How many milliliters of polyethylene glycol 400 will be required to
prepare the ointment? (Answer must be numeric; no units or commas; round final answer to the
nearest WHOLE number.)

Question 49

A pharmacist has calculated that a patient requires 30 mmol of phosphate and 80 mEq of
potassium to be added to the PN. How many milliliters of potassium phosphate and how many
milliliters of potassium chloride will be required? [K-Phos is 3 mmol Phosphate with 4.4 mEq K
per mL and KCl is 2 mEq/K per mL.]

Answer
A 5 mL potassium phosphate and 22 mL potassium chloride
B 15 mL potassium phosphate and 14 mL potassium chloride
C 10 mL potassium phosphate and 18 mL potassium chloride
D 11 mL potassium phosphate and 6 mL potassium chloride
E 18 mL potassium phosphate and 11 mL potassium chloride

Question 50

The pharmacist has an order for heparin 25,000 units in 250 mL D5W to infuse at 2,000
units/hour. The infusion set delivers 60 drops per milliliter. How many drops does the patient
receive per minute?

Answer

A 10 drops per minute

B 12 drops per minute
C 15 drops per minute
D 18 drops per minute
E 20 drops per minute
Answers

1. 65
2. D
3. 3599
4. 154
5. 894
6. 84
7. A, B
8. 91
9. 2.25
10. 39.5
11. D
12. 19
13. 300
14. 92
15. 400
16. 102.9
17. 368
18. 2
19. 31
20. 62
21. B
22. A
23. D
24. C
25. 1.8
26. 1
27. 3050
28. 9.6
29. 250
30. D
31. B
32. 1700
33. B
34. 15
35. 1000
36. 12.6
37. 1650
38. 224
39. 2500
40. 1119
41. 0.005
42. 4.05
43. 8
44. 20
45. D
46. 20
47. 30
48. 531
49. C
50. E